Microsphere Localization and Dose Quantification Using Positron Emission Tomography/CT following Hepatic Intraarterial Radioembolization with Yttrium-90 in Patients with Advanced Hepatocellular Carcinoma

Lea, William; Tapp, Katie N.; Tann, Mark; Hutchins, Gary D.; Fletcher, James; Johnson, Matthew S.

doi:10.1016/j.jvir.2014.06.028

Cited by 24 publications

(77 citation statements)

References 19 publications

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“…Providing the first Gy-for-Gy comparison against MAA SPECT dosimetry for 7 patients, they showed an intraclass correlation of 0.97, in the cohort, with a maximum difference of up to 40% in D T . Similar work showed that in 64 patients with HCC treated with GMS and using VSVs that D NL was 93±33 Gy with on average V 50 > 79 Gy and D T of 173±103 Gy [125]. Recent work used FLUKA to develop a DVK technique for PET-CT scans for 6 patients (3 GMS, 3 RMS) and used DVHs to show D 70 in the range of 25-155 Gy for all patients, and a mean D T of 71-311 Gy [126].…”

Section: Y Pet Imagingmentioning

confidence: 55%

A review of 3D image-based dosimetry, technical considerations and emerging perspectives in 90Y microsphere therapy

Doherty¹

2015

J Diagn Imaging Ther

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Yttrium-90 radioembolization ( 90 Y-RE) is a well-established therapy for the treatment of hepatocellular carcinoma (HCC) and also of metastatic liver deposits from other malignancies. Nuclear Medicine and Cath Lab diagnostic imaging takes a pivotal role in the success of the treatment, and in order to fully exploit the efficacy of the technique and provide reliable quantitative dosimetry that are related to clinical endpoints in the era of personalized medicine, technical challenges in imaging need to be overcome. In this paper, the extensive literature of current 90 Y-RE techniques and challenges facing it in terms of quantification and dosimetry are reviewed, with a focus on the current generation of 3D dosimetry techniques. Finally, new emerging techniques are reviewed which seek to overcome these challenges, such as highresolution imaging, novel surgical procedures and the use of other radiopharmaceuticals for therapy and pre-therapeutic planning.

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Section: Y Pet Imagingmentioning

confidence: 55%

A review of 3D image-based dosimetry, technical considerations and emerging perspectives in 90Y microsphere therapy

Doherty¹

2015

J Diagn Imaging Ther

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“…For the most part, our patients had ≤25% liver tumor burden with no recorded extrahepatic disease and were being treated in a salvage setting. (29,30). No patient in this small study experienced REILD, a rare but serious complication of SIRT that is associated with higher prescribed 90 Y activity in patients treated for unresectable hepatic tumors (31,32 Y-resin groups do not typically reach the threshold required for inducing REILD.…”

Section: Toxicity Assessments and Adverse Eventsmentioning

confidence: 76%

Administered activity and outcomes of glass versus resin 90Y microsphere radioembolization in patients with colorectal liver metastases

Srinivas¹,

Nasr²,

Kunam³

et al. 2016

J. Gastrointest. Oncol.

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“…Prior studies have shown wide variations in measured tumor and parenchymal 90 Y microsphere deposition following lobar administrations [25,30]. In a recent study, Padia et al showed heterogeneous 90 Y microsphere deposition within tumor and portal vein tumor thrombus that appeared to correlate with regions of necrosis on follow-up imaging [25].…”

Section: Discussionmentioning

confidence: 98%

“…Historically, posttherapy imaging was done with Bremsstrahlung imaging [18,19]; however, positron emission tomography (PET) has generally replaced SPECT due to the need for higher resolution imaging to localize dose distribution [18][19][20][21][22][23][24][25][26][27][28][29]. In a recent study focusing on hepatocellular carcinoma patients, Lea et al demonstrated wide variation in measured tumor and parenchymal doses on PET/CT following lobar administration of glass microspheres [30]. This wide variability may lead to heterogeneous tumor response and the potential to under-dose tumors while over-dosing background liver [27,31].…”

Section: Introductionmentioning

confidence: 99%

PET/MRI of hepatic 90Y microsphere deposition determines individual tumor response

Saad¹,

Fowler

Maughan

et al. 2016

Journal of Vascular and Interventional Radiology

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Purpose The purpose of our study is to determine if there is a relationship between dose deposition measured by PET/MRI and individual lesion response to yttrium-90 ( 90 Y) microsphere radioembolization. Materials and Methods 26 patients undergoing lobar treatment with 90 Y microspheres underwent PET/MRI within 66 h of treatment and had follow-up imaging available. Adequate visualization of tumor was available in 24 patients, and contours were drawn on simultaneously acquired PET/MRI data. Dose volume histograms (DVHs) were extracted from dose maps, which were generated using a voxelized dose kernel. Similar contours to capture dimensional and volumetric change of tumors were drawn on follow-up imaging. Response was analyzed using both RECIST and volumetric RECIST (vRECIST) criteria.Results A total of 8 hepatocellular carcinoma (HCC), 4 neuroendocrine tumor (NET), 9 colorectal metastases (CRC) patients, and 3 patients with other metastatic disease met inclusion criteria. Average dose was useful in predicting response between responders and non-responders for all lesion types and for CRC lesions alone using both response criteria (p \ 0.05). D70 (minimum dose to 70 % of volume) was also useful in predicting response when using vRECIST. No significant trend was seen in the other tumor types. For CRC lesions, an average dose of 29.8 Gy offered 76.9 % sensitivity and 75.9 % specificity for response. Conclusions PET/MRI of 90 Y microsphere distribution showed significantly higher DVH values for responders than non-responders in patients with CRC. DVH analysis of 90 Y microsphere distribution following treatment may be an important predictor of response and could be used to guide future adaptive therapy trials.

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Microsphere Localization and Dose Quantification Using Positron Emission Tomography/CT following Hepatic Intraarterial Radioembolization with Yttrium-90 in Patients with Advanced Hepatocellular Carcinoma

Cited by 24 publications

References 19 publications

A review of 3D image-based dosimetry, technical considerations and emerging perspectives in 90Y microsphere therapy

A review of 3D image-based dosimetry, technical considerations and emerging perspectives in 90Y microsphere therapy

Administered activity and outcomes of glass versus resin 90Y microsphere radioembolization in patients with colorectal liver metastases

PET/MRI of hepatic 90Y microsphere deposition determines individual tumor response

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